成都地区10例H7N9患者实验室检测分析

Laboratory Detection and Analysis on 10 Cases of H7N9 Patients in Chengdu

目的探讨成都市公共卫生临床医疗中心2017年收治的10例H7N9患者治疗前、后实验室指标变化及其临床意义。方法(1)病例组(死亡组3例,治愈组7例)治疗前后和对照组(20例)分别检测心肌损伤标志物、D-二聚体,进行比较分析;(2)比较分析死亡组与痊愈组血常规、C反应蛋白、降钙素原、乳酸等感染指标的动态变化。结果与正常对照组比较,治疗前的病例组心肌损伤指标升高(P<0.05),D-二聚体变化不大(P>0.5);治愈组治疗后各项指标除α-HBDH、LDH外较治疗前降低(P<0.05),而死亡组各项指标大幅度升高(P<0.05),尤其D-二聚体升高明显(P<0.05);3例死亡病例各项感染均升高,白细胞及中性粒细胞计数升高,淋巴细胞及血小板计数降低;痊愈病例随病情好转各指标降至正常。结论上述实验室指标是反映H7N9患者病情严重程度的重要指标,对其动态观察对病情发展、病情严重程度、及预后判断提示具有一定的临床意义。

Objective: To investigate the laboratory parameters of 10 H7N9 patients before and after treatment in our hospital in 2017. Methods:(1)To test and compare cardiac marker and D-Dimer in case groups (3 cases in death group and 7 cases in cure group),before and after treatment control group (20 cases);(2)Compare and analyze the dynamic changes of infection indexes in death group and cure group,such as routine blood test,CRP,PLT and LACT. Results: Compare with control group,all laboratory data of cardiac marker increased in case group before treatment(P<0.05),D-Dimer shows little change(P<0.5).After treatment,the indexes in cure group were lower than those before treatment(P<0.05),except α-HBDH and LDH,yet the indexes of death group were much higher(P<0.05), D-Dimer(P<0.05)increased significantly;All the infections,the leukocyte and neutrophil count were increased in 3 dead cases;the lymphocyte and platelet count decreased;Indicators of cured cases decreased to normal with the improvement of the condition. Conclusions: Clinical laboratory data in H7N9 patients has some clinical significance for auxiliary diagnosis in determining the severity of the disease and providing prognostic hints.